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Nearly three years ago, the Affordable Care Act (ACA) implemented a new individual insurance marketplace, along with the promise of stability and affordability. The new individual marketplace was to rival that of the employer sponsored insurance (ESI) marketplace in stability and predictability, while premiums were to rise at rates much lower than the historical average. This paper seeks to evaluate the degree to which these promises have been fulfilled, heading into year four. After more modest increases in 2015 and 2016, there looks to be substantial increases for much of the nation in 2017.

The increasingly higher premium growth from year to year—along with decreasing competition—paints a rather bleak picture of the future of the ACA. If insurers continue to lose money on the exchanges and leave the market, premiums will continue to increase by double digits across the country. While premiums in some areas may not be increasing at a high rate, insurers in those areas will begin to implement higher premium increases to make up for losses sustained elsewhere.